PMID- 37568965
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230814
IS  - 2075-4418 (Print)
IS  - 2075-4418 (Electronic)
IS  - 2075-4418 (Linking)
VI  - 13
IP  - 15
DP  - 2023 Aug 4
TI  - Diabetic Ketoacidosis in Children and Adolescents; Diagnostic and Therapeutic 
      Pitfalls.
LID - 10.3390/diagnostics13152602 [doi]
LID - 2602
AB  - Diabetic ketoacidosis (DKA) represents an acute, severe complication of relative 
      insulin deficiency and a common presentation of Type 1 Diabetes Mellitus (T1DM) 
      primarily and, occasionally, Type 2 Diabetes Mellitus (T2DM) in children and 
      adolescents. It is characterized by the biochemical triad of hyperglycaemia, 
      ketonaemia and/or ketonuria, and acidaemia. Clinical symptoms include 
      dehydration, tachypnoea, gastrointestinal symptoms, and reduced level of 
      consciousness, precipitated by a variably long period of polyuria, polydipsia, 
      and weight loss. The present review aims to summarize potential pitfalls in the 
      diagnosis and management of DKA. A literature review was conducted using the 
      Pubmed/Medline and Scopus databases including articles published from 2000 
      onwards. Diagnostic challenges include differentiating between T1DM and T2DM, 
      between DKA and hyperosmolar hyperglycaemic state (HHS), and between DKA and 
      alternative diagnoses presenting with overlapping symptoms, such as pneumonia, 
      asthma exacerbation, urinary tract infection, gastroenteritis, acute abdomen, and 
      central nervous system infection. The mainstays of DKA management include careful 
      fluid resuscitation, timely intravenous insulin administration, restoration of 
      shifting electrolyte disorders and addressing underlying precipitating factors. 
      However, evidence suggests that optimal treatment remains a therapeutic 
      challenge. Accurate and rapid diagnosis, prompt intervention, and meticulous 
      monitoring are of major importance to break the vicious cycle of life-threatening 
      events and prevent severe complications during this potentially fatal medical 
      emergency.
FAU - Kostopoulou, Eirini
AU  - Kostopoulou E
AUID- ORCID: 0000-0002-7051-7537
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Sinopidis, Xenophon
AU  - Sinopidis X
AUID- ORCID: 0000-0002-0878-0668
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Fouzas, Sotirios
AU  - Fouzas S
AUID- ORCID: 0000-0001-7617-9076
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Gkentzi, Despoina
AU  - Gkentzi D
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Dassios, Theodore
AU  - Dassios T
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Roupakias, Stylianos
AU  - Roupakias S
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
FAU - Dimitriou, Gabriel
AU  - Dimitriou G
AD  - Department of Paediatrics, University of Patras, 26504 Patras, Greece.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230804
PL  - Switzerland
TA  - Diagnostics (Basel)
JT  - Diagnostics (Basel, Switzerland)
JID - 101658402
PMC - PMC10416834
OTO - NOTNLM
OT  - children
OT  - diabetic ketoacidosis
OT  - diagnosis
OT  - management
OT  - pitfalls
OT  - type 1 diabetes mellitus
COIS- The authors declare no conflict of interest.
EDAT- 2023/08/12 10:46
MHDA- 2023/08/12 10:47
PMCR- 2023/08/04
CRDT- 2023/08/12 01:05
PHST- 2023/06/26 00:00 [received]
PHST- 2023/07/21 00:00 [revised]
PHST- 2023/08/03 00:00 [accepted]
PHST- 2023/08/12 10:47 [medline]
PHST- 2023/08/12 10:46 [pubmed]
PHST- 2023/08/12 01:05 [entrez]
PHST- 2023/08/04 00:00 [pmc-release]
AID - diagnostics13152602 [pii]
AID - diagnostics-13-02602 [pii]
AID - 10.3390/diagnostics13152602 [doi]
PST - epublish
SO  - Diagnostics (Basel). 2023 Aug 4;13(15):2602. doi: 10.3390/diagnostics13152602.